Laser hair removal after surgery vs. surgery alone for the treatment of pilonidal cysts: a retrospective case-control study

BACKGROUND

Based on the presumed role of hair in pilonidal cyst (PNC) pathogenesis, laser epilation has been used to decrease recurrences. However, most of the data rely on case reports and uncontrolled series, and the rare controlled studies reported conflicting results. The objective of this study was to investigate the efficacy of laser hair removal (LHR) to decrease the recurrence rate after surgery of PNC vs. surgery alone.

METHODS

We conducted a retrospective monocentric case-control study in the departments of Pediatric Surgery and Laser Center of Dermatology of the University Hospital of Nice in France from January 2010 to June 2017. We included all patients with PNC who had surgery during the period, and we compared patients who had LHR after surgery to those having surgery alone. The main outcome was the prevalence and number of recurrences of PNC in each group.

RESULTS

Twelve patients - eight treated with alexandrite laser and four patients with Nd : YAG - were included in the cases group; 29 patients treated with surgery alone were included in the control group. The mean and the median number of laser sessions were 4.2 and 5, respectively (extremes 1-10). The postsurgical recurrence rate without LHR was 51.7%, and their number varied from 1 to 3. A significant decrease in the recurrence rate was observed after LHR (8.3%) compared to control group (P < 0.001). The median duration before recurrence was 14 months for surgery alone. The median follow-up was 18 months (1-30 months) for LHR group and 30 months (6-72 months) for surgery alone group. Two patients had abnormal healing or persistent sinus after surgery alone compared to none in the group who undergone laser procedure after surgery.

CONCLUSIONS

Laser hair removal decreases the risk of delayed healing and of recurrences of PNL after surgical procedure.

Granulomatous rosacea: a case report

Background

Granulomatous rosacea is a rare chronic inflammatory skin disease with an unknown origin. The role of Demodex follicularum in its pathogenesis is currently proved.

Case presentation

We report a case of a 54-year-old Moroccan man with a 3-month history of erythematous, nonpruritic papules on the lateral side around the eyes. Dermoscopy and histology confirmed the diagnosis of granulomatous rosacea.

Conclusions

We describe another clinical presentation of granulomatous rosacea with a clinical-dermoscopic-pathological correlation.

Defining the mimics and clinico-histological diagnosis criteria for mycosis fungoides to minimize misdiagnosis

Background

Mycosis fungoides (MF) is a significant diagnostic challenge; it has various differential diagnosis especially at an early stage. Our aim was to describe mimics of MF clinically and histologically, and to define significant diagnostic criteria of the disease.

Methods

This was a retro-prospective cohort of 370 patients in whom the diagnosis of MF was suspected clinically.

Results

MF was histologically confirmed in 15.4% of cases and rejected in 84.5%. Other identified histologically diagnosis were eczema, psoriasis; nonspecific dermatitis, lichen, lupus; pseudolymphoma, parapsoriasis and toxidermia. 4 patients with palmoplantar MF were wrongly treated as eczema, and 10 patients with psoriasiform MF were initially treated as psoriasis. We also described the clinical, histological and immunohistochemistry diagnostic criteria for distinguishing MF from benign dermatosis.

Conclusions

Misdiagnosis of MF was a real problem for this study, because it shared common clinical and histological characteristics with other inflammatory diseases like eczema and psoriasis. Therefore, defining significant clinico-histological diagnosis criteria of MF would be of great help and would increase the accuracy of the diagnosis.